Need someone to look at Hansel's spreadsheet and give advice?

[Zekono]

Hi Feline Diabetes Forum

We've had our cat (Hansel) on insuline for a few months now. The diabetes was diagnosed at the vet. He is getting Prozinc.

Symptoms were the usual ones(?):
- Staying near a water source, drinking a lot
- Huge amount of urine (pees at least 20 seconds, often longer)
- Dont remember if he ate more or less at the start, he did lose a lot of weight during that time (especially on his back, his belly stayed kinda fat)
- Now even on 5 IE he's eating SO much, for sure too much.

But the food doesn't come out well:
- Diarrhea
- Vomiting

It is hard to check how much he eats, the vet told us he always need to have food available.
- Dry food is accessible the whole day
- At injection time, he gets 1/3 of a Felix Sensations bag (28 gr/1 oz)

Spoiler: Wet food

Nutritional Additives:

• Vitamin A (655 IU/kg), Vitamin D3 (100 IU/kg), Vitamin E (15 IU/kg), Ferrous sulfate monohydrate (7.6 mg/kg), Calcium iodate anhydrous (0.19 mg/kg), Copper(II) sulfate pentahydrate (0.66 mg/kg), Manganese(II) sulfate monohydrate (1.5 mg/kg), Zinc sulfate monohydrate (13 mg/kg), Taurine (413 mg/kg)

Turkey, Beef, Lamb, Duck in Sauce:

• Vitamin A (724 IU/kg), Vitamin D3 (111 IU/kg), Vitamin E (16 IU/kg), Ferrous(II) sulfate monohydrate (8.3 mg/kg), Calcium iodate anhydrous (0.21 mg/kg), Copper(II) sulfate pentahydrate (0.73 mg/kg), Manganese(II) sulfate monohydrate (1.6 mg/kg), Zinc sulfate monohydrate (14.8 mg/kg), Taurine (456 mg/kg), Flavors.

Technological Additives:

• Locust Bean Gum: (2700 mg/kg)

Analytical Constituents

Flavor Variations of the Country in Sauce:

• Crude protein: 12.5%
• Crude fat: 2.5%
• Crude fiber: 0.05%
• Crude ash: 2.5%
• Moisture: 80.0%
• Omega-6 fatty acids: 0.4%

- The dry food that's available the whole day is Ultima Cat Urinary Tract

Spoiler: Dry food

Composition
Chicken (17%), corn protein, dehydrated poultry protein, corn meal, whole corn, dehydrated pork protein, whole wheat (6%), dried peas (5%), animal fat, whole barley (4%), hydrolyzed animal protein, minerals, dehydrated carrots (0.5%, equivalent to 4% fresh carrots).

Additives
Nutritional additives:

Vitamin A (27,000 IU/kg), vitamin D3 (1,200 IU/kg), vitamin E (650 mg/kg), vitamin C (ascorbyl monophosphate calcium sodium salt) (190 mg/kg), taurine (1,100 mg/kg), biotin (1 mg/kg), ferrous sulfate monohydrate (iron 86 mg) (260 mg/kg), potassium iodide (iodine 1.4 mg) (1.9 mg/kg), copper sulfate pentahydrate (copper 8.8 mg) (33 mg/kg), manganese sulfate monohydrate (manganese 40 mg/kg) (123 mg/kg), zinc sulfate monohydrate (zinc 149 mg) (405 mg/kg), sodium selenite (selenium 0.1 mg/kg) (0.2 mg/kg).

Analytical constituents:

Crude protein: 34.0% Crude fat: 14.0% Crude fiber: 2.0% Crude ash: 7.6% Sodium: 0.65% Omega-3 fatty acids: 0.2% Omega-6 fatty acids: 2.5%

- It's hard to feed him at set times. We have another cat (Schmidt) with problems and he needs to be able to eat urinary tract food whenever. The problem is that Schmidt eats the whole day in very small doses. If we leave that out, Hansel would eat it all.

I don't know why the numbers stay more or less the same, 5 IE already seems so much and the mmol should be 8-10 at this dose, right? Could this be insuline resistance? We will try 5 IE this weekend.
The vet wants to start some new experimental medicine on him but we are a bit scared for that.

We bought a BG checker and measured each 2 hours.
2 IE is missing, we spoke with the vet about it and she told us to adjust to 2.5 IE then.
All the dose adjustions are in consultations with the vet.
Here is a table, the numbers are mmol

Thanks for taking your time to read

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

I have a couple of observations. We recommend that a diabetic cat eats a low carbohydrate diet. We consider low carb as under 10% although most people here feed their cat a food that's in the 5% range. Most dry food is not low in carbohydrates. In all likelihood, this is what is keeping Hansel's numbers high and causing him to need more insulin. If you Google "cat food carbohydrate calculator" you can plug in the nutritional information from the guaranteed analysis and you will see what the percent of carbohydrates is. You may need to find a way to manage the food for your two cats. It sounds like what you're feeding Hansel isn't agreeing with him. I'd consider a different, low carb food.

Prozinc is a good insulin for treating feline diabetes! However, you are raising doses quite aggressively. It would be helpful to know what the timeline is for when you're raising the dose. It's also helpful to see data from both the morning and evening cycles. We have guidelines for using Prozinc that provides information on dosing.

Without more information on blood glucose levels, there really isn't a good way to know if this is insulin resistance or some other high dose condition. This post on helping us to help you will provide information on setting up a spreadsheet and your signature. The spreadsheet is a way to track your test data and see your cat's progress. The signature will contain basic information about your cat so we don't keep asking you the same questions.

 

[Zekono]

Hello Sienne and Gabby

Thank you for taking your time to respond. I will try to provide some more info.
Here are the dates of the adjustments, I've converted them to US format.
The noon BG is measured right after his noon dose. The midnight one is measured before his midnight dose.
There is a lot of time between the first few dates, our vet did not tell us to higher the dose at that time.

I've done some calculations (hopefully the right way) and landed on 4.5% carbs for the wet food, and 42.4% carbs for the dry food.
Could this be correct?

The percentage from the dry food carbs seems absurdly high. Is that why he's throwing up most of it?
Since he eats dry food most of the day, this could potentially be a big factor if I understand correctly.

It will be a bit hard to manage with 4 cats with not always being home too. Luckily they are inside cats, we have some cat cams too.
The best solution I see is either change them all to wet food permanently (I'm afraid we can't financially handle that) or do a one-time investment of the food thingies that "recognize" the cat and open up when they come near the camera.

Thank you for the link to the ProZinc thread. It looks like we're doing most of that correctly. Do we need to do a 24 hour measurement instead?
I will get started on the spreadsheet.

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
I can see the spreadsheet, thanks for setting that up so quickly!
Are you giving the insulin twice a day? I can’t see any doses of insulin recorded anywhere for either am or pm cycles at the moment.

I've done some calculations (hopefully the right way) and landed on 4.5% carbs for the wet food, and 42.4% carbs for the dry food.
Could this be correct

Yes that is correct. Most dry cat food is very high carbs and totally unsuitable for all cats, whether they are diabetic or not.

The percentage from the dry food carbs seems absurdly high. Is that why he's throwing up most of it?
Since he eats dry food most of the day, this could potentially be a big factor if I understand correctly.

I don’t know if that is why he is throwing up. But it is probably a big factor in why he is not responding to the insulin doses so far.
Feeding high carb dry food is like feeding a diabetic child candy and sweets all the time and wondering why they are not responding to the insulin doses.

It will be a bit hard to manage with 4 cats with not always being home too. Luckily they are inside cats, we have some cat cams too.
The best solution I see is either change them all to wet food permanently (I'm afraid we can't financially handle that) or do a one-time investment of the food thingies that "recognize" the cat and open up when they come near the camera.

It is always a challenge to feed a diabetic cat in a multi cat household. The easiest way is to swap them all over to a low carb wet diet.
What food does Schmidt need to eat? Is it a dry food? If so that will be very high carb as well and honestly he would be far better off with some sort of lower carb wet/ canned food.
Dry food is 7% moisture, and canned food is 78% moisture. All cats need a lot of moisture in their food for their kidneys, and need encouraging to drink more fluids for their kidney health. I feed my cats a homemade raw diet and add water to the feed each time. I would never again feed my cats dry food.
Back to your multicast household!…
I think your options are:

• Swapping them all to a low carb wet diet…this would be the easiest option. You we have to look for some foods that are not too expensive.
• Look into getting automatic timed feeders with a chip attached that only lets Schmidt eat the food. And let all the others eat the low carb wet food.
• An automatic timed feeder with chips for Schmidt and Hansel so they can both eat their appropriate foods

The first option would be the healthiest one by far for all the cats. Feeding a high carb dry food will only cause problems down the track such as more diabetes and kidney failure.
What country do you live in? We may be able to help with some cheaper options for canned low carb food.

If/when you decide to swap Hansel over to a low carb wet diet, you are going to have to do it when you are able to monitor the BGs closely because changing from a high carb to a low carb food can drop the BGs dramatically. I would suggest doing it over several days slowly and with our help so we can keep an eye on what the BGs are doing. He will most likely need a reduction in dose.

 

[Zekono]

Yes, at noon and at midnight. Sorry I'm having some problems with the sheet, apparently the first result has to be done before the insulin injection and we did it right after. The AMPS column has the BG from right after the first result.

That is very interesting, I didn't know it was like that. When we asked the vet during the diagnoses, she told us it's fine to keep him on the same food.
My fiancee gave a full bag of the wet food yesterday night and I didn't find out until this morning, so I told her it was very dangerous!
But somehow it worked out, it's the first night in a long time he didn't throw up.
So he got 1+1/3 of the small wet food bags yesterday. (so total dose was 4x 1/3 bag, normally he gets 2x 1/3 bag).
He ate less dry food during the night for sure, but maybe we should try 1/2 bag in the morning and 1/2 bag in the evening for 2 days and then take an accurate 12 hour recording with 2 hours in between each time.

We will see if we can handle it financially to go to low carb wet food, there are probably good options but Schmidt is a very picky eater but I'm confident we can figure out a system somehow.
Maybe Hansel and Schmidt both need collars with chips. I'm worried that they will go crazy from wearing that so we'll explore options with camera recognition too or see what else we can buy.

Schmidt had bladder stones, his life was on a thread and he had to go into surgery. My fiancee was worried he couldn't eat wet food as she thought there might be too much salt in it?
Would you say wet food is always a better option?
The moisture will help a lot probably for his kidney/bladder since he does not drink thaat much.

What kind of homemade raw diet with water do you give the cats? I'm very open to suggestions and ideas.
I live in Belgium. We usually get our cat litter and food on https://www.zooplus.nl/

Yeah I see the reasoning why the BGs can drop too much since he will eat less dry food if he eats more wet food. We will adjust it very slowly.

Thanks for the response.

 

[Bron and Sheba (GA)]

Yes, at noon and at midnight. Sorry I'm having some problems with the sheet, apparently the first result has to be done before the insulin injection and we did it right after. The AMPS column has the BG from right after the first result.

Can you put the dose of insulin you gave in each column please so we can see it? I’m not sure what dose you are giving morning and night. Thanks

My fiancee gave a full bag of the wet food yesterday night and I didn't find out until this morning, so I told her it was very dangerous!

How big was the bag of food?
Do your cats have microchips in their necks? There are feeders that recognises those chips and only let the cat with the correct chips at from them.

Schmidt had bladder stones, his life was on a thread and he had to go into surgery. My fiancee was worried he couldn't eat wet food as she thought there might be too much salt in it?

If the wet food is AFFCO approved it is suitable and won’t have too much salt in it. Wet food is far better for all cats as they need more moisture than any dry food has.

What kind of homemade raw diet with water do you give the cats? I'm very open to suggestions and ideas.

I buy meat from the supermarket for my cats from the section I buy my meat. So the meat that is for human consumption.
I use chicken, beef, lamb, kangaroo, pork and liver and kidneys and bones. There are a few ways it can be done. I find it is much cheaper to buy human grade meat to feed them than buying canned food. My current 8 year old cats have never been fed canned food or dry food. I bought them some freeze dried treats to try (they are low carb) and they didn’t know what to do with them, they didn’t recognise them as food.
But you need to be sure you are feeding a nutritionally balanced diet.
It can be time consuming cutting up the food. I always buy it and freeze it straight away and get out what I need each day. Others will do big batches and freeze it so it is ready to use. Some cut up the food and others use a grinder.
There are supplements (premixes) you can buy to add to the food to make it complete. T C feline is one which is available in the US and Canada…not sure about Europe.
I live in Australia so I’m not sure what supplemts are available in Belgium. I’ll tag @Gill & George as she is in Spain. She may have an idea.
Here is a link to excellent information written by vet Lisa Pierson who made many of the food lists we have on this site. It uses several individual supplements for the raw food to be nutritionally complete
https://catinfo.org/making-cat-food/

 

[Diane Tyler's Mom GA]

@Zekono
Might be a good idea to set up your signature , I would also add Belgium
Can you set up your signature
Your signature should be in gray letters, do you see mine at the end of my post
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Bexacat or Senvelgo (if applicable) and dates
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

 

[Sienne and Gabby (GA)]

Just to give you more background on feline nutrition, I've linked an excellent website on the topic The website is authored by a vet. She's very supportive of a canned or raw food diet. I feed my cats a partially raw food diet. I use a pre-mix -- this is an add in to the food I buy at the grocery store. You add water and the pre-mix which makes the raw, ground food nutritionally complete.

I suspect that your kitty is throwing up due to the amount of fat in the dry food.

If I can also offer a suggestion. Please get at least one test, in addition to your PMPS test, during the PM cycle. Many cats experience lower numbers at night. In addition, without any PM tests, you're missing half of your data.

 

[Heike & BInie]

Hi Staci, wow, what a long night! I see pictures of you lying tired on the sofa with the phone in your hand to not miss the next feeding time. Miss Ivy happy about the extra attention and the jummy food. Purring and making biscuits. I remember there was the problem she was not eating the higher carb food. Did you find a solution for that?
Hope you get some sleep tonight and she stays stable.

 

[Zekono]

Can you put the dose of insulin you gave in each column please so we can see it? I’m not sure what dose you are giving morning and night. Thanks

How big was the bag of food?
Do your cats have microchips in their necks? There are feeders that recognises those chips and only let the cat with the correct chips at from them.


If the wet food is AFFCO approved it is suitable and won’t have too much salt in it. Wet food is far better for all cats as they need more moisture than any dry food has.

I buy meat from the supermarket for my cats from the section I buy my meat. So the meat that is for human consumption.
I use chicken, beef, lamb, kangaroo, pork and liver and kidneys and bones. There are a few ways it can be done. I find it is much cheaper to buy human grade meat to feed them than buying canned food. My current 8 year old cats have never been fed canned food or dry food. I bought them some freeze dried treats to try (they are low carb) and they didn’t know what to do with them, they didn’t recognise them as food.
But you need to be sure you are feeding a nutritionally balanced diet.
It can be time consuming cutting up the food. I always buy it and freeze it straight away and get out what I need each day. Others will do big batches and freeze it so it is ready to use. Some cut up the food and others use a grinder.
There are supplements (premixes) you can buy to add to the food to make it complete. T C feline is one which is available in the US and Canada…not sure about Europe.
I live in Australia so I’m not sure what supplemts are available in Belgium. I’ll tag @Gill & George as she is in Spain. She may have an idea.
Here is a link to excellent information written by vet Lisa Pierson who made many of the food lists we have on this site. It uses several individual supplements for the raw food to be nutritionally complete
https://catinfo.org/making-cat-food/

I've updated the sheet, he is now getting 5U at noon and 5U at midnight.
Hopefully it's clear, I'm still trying to figure it out a bit. Please let me know if something is not correct.

It was one of these small baggies of 85gr / 3 oz

Yes, they have microchips. I don't understand how this works though. Is it some kind of sensor?
There's a way for the chips to communicate without "recharging" or does a new chip need to be planted?

Thank you for the answer about food and the detailed explanation and for the link about making food.

We are doing a 12-hour test now with 1.5 oz at noon, free access to dry food in between and 1.5 oz at midnight.
We will record his BG every 2 hours and just measured the first AMPS.

 

[Bron and Sheba (GA)]

Now that you have the SS set up well, do you think you could record the data every day so we can see patterns?
And don’t forget the pm cycle is just as important as the am cycle. At the moment you don’t have any tests done in the pm cycle, so you are missing half the data.
Cats often drop lower at night.

with the feeders that use microchips , it is my understanding that you insert the microchip number of your cat into the machine and only that cat will be able to feed from that feeder.

 

[Zekono]

Now that you have the SS set up well, do you think you could record the data every day so we can see patterns?
And don’t forget the pm cycle is just as important as the am cycle. At the moment you don’t have any tests done in the pm cycle, so you are missing half the data.
Cats often drop lower at night.

with the feeders that use microchips , it is my understanding that you insert the microchip number of your cat into the machine and only that cat will be able to feed from that feeder.

We are currently sampling the blood from his ear and feel they need some time to heal after a day of taking samples. We've tried it on his paws as well but there's not enough blood for the meter most of the times, since we don't want to hurt him too much we stopped doing that. I don't know if every day is realistic or maybe there's another way?
The PM cycle is hard to measure with our current schedule/rl obligations, during the day we can usually test him for 12 hours though.

Those feeders sound interesting, we'll look into them more!

In wet food, do we need to look for "Diabetes" specific food or will the normal wet food work?
Here is some affordable non-diabetic food (scroll down a bit to Ingredients, more) and diabetic food if anyone wants to take a look.

We did some calculations and the non-diabetic wet food is €40 per month per cat, so €160 (or €200 if we give Hansel diabetic wet food)
That is impossible for us financially
We will look into finding another way

I've also updated my signature, hopefully it's correct now.

 

[Zekono]

First test with the wet food 42.5 gr/1.5 oz noon and 42.5 gr/1.5oz midnight, with dry food available throughout the day.

AMPS = 481mg/dL or 26.7 mmol/L
Right before we give the noon portion wet food.

After +2 his BG is 355 mg/dL or 19.7 mmol/L
He hasn't eaten dry food yet, only 42.5gr/1.5 oz wet food.
This is his lowest recording ever so far.

After +4 his BG is 286 mg/dL or 15.9 mmol/L
He ate a bit of dry food about 45 minutes before the sample.
New lowest recording.

After +6 his BG is 387 mg/dL or 21.5 mmol/L
He ate no more dry food since the dry food 2h 45m ago.

After +8 his BG is 473 mg/dL or 26.3 mmol/L
He ate a bit of dry food about 45 min ago.

After +10 his BG is 513 mg/dL or 28.5 mmol/L
He ate more dry food about 1.5 hours before this

After +12 his BG is 513 mg/dL or 28.5 mmol/L (PMPS)
Right before we give the midnight portion wet food.
He ate no more dry food since the last portion

After +2 of PMPS his BG is 405 or 22.5 mmol/L
He ate no more dry food since the last portion

I'm not finding a way to eat when he eats his portions in the spreadsheet. I'm mentioning it here but is this important?

 

[Tim & Pookey]

I don't understand how this works though. Is it some kind of sensor?
There's a way for the chips to communicate without "recharging" or does a new chip need to be planted?

Hi there, I can help with the technical side of this (engineer here).

A lot of these feeders use passive RFID technology. The tags don’t have batteries. The feeder has an antenna that broadcasts a signal, which then energizes the tag to allow for data exchange. There is logic in the feeder that makes a decision based on a unique ID written to the tag memory to allow eating or not.

There is active RFID too, where tags might have batteries, which allows for a larger read/write range.

 

[Diane Tyler's Mom GA]

I've also updated my signature, hopefully it's correct now

Your signature looks good , I would add Belgium to it also
@Zekono

 

[Sienne and Gabby (GA)]

Hansel's ears will be fine with testing. You do not need to skip tests to allow his ears to heal. If you look at some of our spreadsheets, you'll see how often some of us test (or tested, like in my case). You could test a bit less frequently.

It's very helpful to get at least one test during the PM cycle. We encourage members to get a test before you go to bed so you know that Hansel is in a safe blood glucose range before you go to sleep. Without any PM tests, you could easily miss low numbers since many cats experience lower numbers at night. In addition, without any PM tests, you're missing half of your data.

With regard to food, you can't choose a food based only on the ingredients. Looking at the Felix brand that you're using, all of the varieties appear to contain sugar. You need information that reflects the guaranteed analysis or the "as fed" analysis. These percentages can be input into a cat food carbohydrate calculator (there are several on the web) and will give you the amount of carbohydrates in what you're feeding Hansel. I'm concerned that what you're feeding your cat is high in carbs which is why his blood glucose numbers are as high as they are.

You do not need to be feeding your cat a diabetes specific diet. Any canned food that is under 10% carbohydrate is fine. Most members feed their cat foods that are in the 5% range. This is a list of foods available in the UK. There is information on the amount of carbs in the food. I don't know if any of these are available in Belgium.

 

[Zekono]

Thank you for the responses.

We started at noon and were normally ending at midnight.
Should the PM test be 2 hours after the midnight shot? I will try to get a 02:00 am test in.

Regarding the % of carbs, when I enter this on a calculator website I got this result. (2.45% carbs)
It seems like a very low % which is weird since it has sugar in the ingredient table too. Can that be accurate or am I doing something wrong? I used this website for it and this one gives the same result.

We will look into the canned food from the supermarket and pet store too.
Hansel is not at all picky, but Schmidt wouldn't eat any of the wet food from there and he's a cat that needs urinary tract food.

There might be some of those foods in the sheet available here, since we do have a zooplus in Belgium.

 

[Zekono]

First test with the wet food 42.5 gr/1.5 oz noon and 42.5 gr/1.5oz midnight, with dry food available throughout the day.

AMPS = 481mg/dL or 26.7 mmol/L
Right before we give the noon portion wet food.

After +2 his BG is 355 mg/dL or 19.7 mmol/L
He hasn't eaten dry food yet, only 42.5gr/1.5 oz wet food.
This is his lowest recording ever so far.

After +4 his BG is 286 mg/dL or 15.9 mmol/L
He ate a bit of dry food about 45 minutes before the sample.
New lowest recording.

After +6 his BG is 387 mg/dL or 21.5 mmol/L
He ate no more dry food since the dry food 2h 45m ago.

After +8 his BG is 473 mg/dL or 26.3 mmol/L
He ate a bit of dry food about 45 min ago.

After +10 his BG is 513 mg/dL or 28.5 mmol/L
He ate more dry food about 1.5 hours before this

After +12 his BG is 513 mg/dL or 28.5 mmol/L (PMPS)
Right before we give the midnight portion wet food.
He ate no more dry food since the last portion

After +2 of PMPS his BG is 405 or 22.5 mmol/L
He ate no more dry food since the last portion

I'm not finding a way to eat when he eats his portions in the spreadsheet. I'm mentioning it here but is this important?

I've updated the sheet and gave some more info about the food here.
We can do a new test earliest on thursday.

 

[Zekono]

Updated the sheet with a new test. Should I just post the updates here for feedback or make a seperate thread somewhere?
We are a bit hesitant to give him more wet food on this insulin dose since his lowest measurement was already 10.4 (or 187).
Would love to hear some thoughts to help our little boy

 

[Diane Tyler's Mom GA]

Updated the sheet with a new test. Should I just post the updates here for feedback or make a seperate thread somewhere?
We are a bit hesitant to give him more wet food on this insulin dose since his lowest measurement was already 10.4 (or 187).
Would love to hear some thoughts to help our little boy

@Zekono
Tagging Suzanne for you since she is familiar with Prozinc to take a look at your spreadsheet

One question Looking at the dates on your spreadsheet I see you are not testing every day. ?
Can you fill in how many units you gave on 12/21/24 at noon
You need to start getting yes s in every day and some tests in after midnight

I see your shooting times are noon and then at midnight.

If I were you I would change your title and put
? Need someone to look at Hansel's spreadsheet and give advice
To change your title look to the right and tap on Thread Tools . Then tap on Edit Title and put what I told you then tap save
@Suzanne & Darcy

 

[Zekono]

@Zekono
Tagging Suzanne for you since she is familiar with Prozinc to take a look at your spreadsheet

One question Looking at the dates on your spreadsheet I see you are not testing every day. ?
Can you fill in how many units you gave on 12/21/24 at noon
You need to start getting yes s in every day and some tests in after midnight

I see your shooting times are noon and then at midnight.

If I were you I would change your title and put
? Need someone to look at Hansel's spreadsheet and give advice
To change your title look to the right and tap on Thread Tools . Then tap on Edit Title and put what I told you then tap save
@Suzanne & Darcy

Correct, we haven't tested every day. Unfortunately, our current schedule does simply not allow it... we are trying to do what we can.
We will try to set things up next week so we can get three consecutive days in and another one after midnight. Hopefully a night cycle as well.

I've changed the title, thank you for explaining how to do it! And upated the sheet so it mentions 5 Units at noon as well.

We also bought some diabetes (dry) food, Kattovit Diabetic. Here are the details. We cannot find info about the carb matter with the calculator as the moisture level is not mentioned, so we're contacting Kattovit support to ask about it.

Spoiler: Dry Kattovit Diabetes food

But we're planning to give mainly wet food once we figure all of this out.

 

[Sienne and Gabby (GA)]

You do not need to be testing every 2 hours. You need to always test prior to giving a shot. The typical order is to test, feed, then shoot. In addition to your pre-shot test, you want to get a minimum on one additional test each cycle -- one test during the AM and the PM cycles. Obviously, more tests are better than fewer tests but a great deal depends on interpreting your cat's spreadsheet. We encourage members to get a PM test before you go to sleep. You want to be sure your cat is in safe numbers overnight.

Just so. you're aware, in the US, there are only 2 dry cat foods that are low in carbs. There are many prescription diabetic dry foods and all of them are at least medium, if not high in carbohydrates. I would not be surprised if the Kattovit dry food is high in carbs.

 

[Zekono]

You do not need to be testing every 2 hours. You need to always test prior to giving a shot. The typical order is to test, feed, then shoot. In addition to your pre-shot test, you want to get a minimum on one additional test each cycle -- one test during the AM and the PM cycles. Obviously, more tests are better than fewer tests but a great deal depends on interpreting your cat's spreadsheet. We encourage members to get a PM test before you go to sleep. You want to be sure your cat is in safe numbers overnight.

Just so. you're aware, in the US, there are only 2 dry cat foods that are low in carbs. There are many prescription diabetic dry foods and all of them are at least medium, if not high in carbohydrates. I would not be surprised if the Kattovit dry food is high in carbs.

Oh, the 2 hours thing was because our vet told us to do it like that, it seemed logical so we just did it that way.
I'll add a PM shot next time again. That's fine to do 1 or 2 hours after his midnight shot?

Is it not dangerous to take limited tests in the 12 hour cycle?
For example on the sheet I entered data there was a result of 187 and 437.
I can imagine giving less carbs or higher dose would make his blood sugar too low and it's hard to estimate with that big of a swing throughout the day?

We'll await Kattovits response but we are afraid to transition him to wet food fully suddenly as the 5U might be too high then.

 

[Sienne and Gabby (GA)]

I'm wondering if your vet was suggesting that you get a curve. A curve is testing every 2 hours for a 12-hour period. The idea behind getting a curve is that you are able to see when insulin starts to work ("onset"), where the low point ("nadir") falls, and how long the effect of the insulin lasts ("duration"). We typically suggest getting a curve once a week until you have a sufficient amount of data to know how your cat is responding to insulin.

You do want to get tests during both the AM and PM cycles. Many cats experience lower numbers at night which is why you really need to get some PM tests. There's no way to know if Hansel's blood glucose numbers will be the same during the PM cycle as they are during the AM cycle. It's not a safe assumption. My kitty started her day in the 400s then dropped into the 40s and was back at the 400s by PMPS. Her PM cycle stayed high. I've had the reverse happen as well -- lower numbers at night compared to daytime tests. It should be fine to get a test 2 hours after you give your PM shot. If you see a big drop in numbers, you may need to set an alarm or stay up and test.

At least given my thoughts about testing, more tests are always better than fewer tests. To some degree, you get to have an idea of how your cat is responding to insulin although, intuition is not infallible. My tests were clustered during the early part of the cycles. Gabby had an early onset and nadir. Once that was clear, I knew when to test more.

One question, does the 12:00 shot time work for you? I ended up moving my shot time to 5:00 because I needed time in the mornings to get tests before I left for work and I couldn't stay up overly late at night.

 

[Zekono]

I don't know how much if he eats more or less during the night, so it'll be good to get some data on that too (will do it this weekend).
His nadir on the last curve was 2-4 hours after the shot, so I'll try to numbers on those times for sure.

Indeed, the 12:00 shot works best for our schedule.
It's hard to keep track of the times and amounts he eats, especially at night.
We don't really know how to administer it safely without risking a hypo, so right now he east 2.25 oz wet food at noon, 2.25 oz wet food at midnight while having free access to dry food all the time.

We can actually test from tomorrow on until sunday. What would your suggestion be?
Should we add a little bit of wet food each day?

 

[Diane Tyler's Mom GA]

@Zekono
Can you please add SLGS to your signature also since Hansel is still eating dry

 

[Diane Tyler's Mom GA]

I don't know how much if he eats more or less during the night, so it'll be good to get some data on that too (will do it this weekend).
His nadir on the last curve was 2-4 hours after the shot, so I'll try to numbers on those times for sure.

Indeed, the 12:00 shot works best for our schedule.
It's hard to keep track of the times and amounts he eats, especially at night.
We don't really know how to administer it safely without risking a hypo, so right now he east 2.25 oz wet food at noon, 2.25 oz wet food at midnight while having free access to dry food all the time.

We can actually test from tomorrow on until sunday. What would your suggestion be?
Should we add a little bit of wet food each day?

@Sienne and Gabby (GA)

 

[Sienne and Gabby (GA)]

If you start to see a consistent pattern with the low point in the cycle falling somewhere in the +2 to +4 range, it would suggest that Hansel has an early nadir. (My cat was similar. Her nadir was typically before +4 except when it wasn't.) It gave me flexibility since I was getting up early to monitor her before I left for work. One thought with an early nadir and food is to consider "front loading" the cycle. In other words, if numbers are going to be low their lowest at nadir, give Hansel the most of his food prior to nadir. I gave Gabby several installments of her meals. She got fed at pre-shot, then at +1, +2, and +3.

As for food, you can leave food freely available. A timed feeder was a huge help for me. If you are monitoring how much Hansel eats, measure what you leave out. Remember to pick up food 2 hours before shot time and measure what you're picking up. The difference will tell you how much he's eating.

 

[Zekono]

If you start to see a consistent pattern with the low point in the cycle falling somewhere in the +2 to +4 range, it would suggest that Hansel has an early nadir. (My cat was similar. Her nadir was typically before +4 except when it wasn't.) It gave me flexibility since I was getting up early to monitor her before I left for work. One thought with an early nadir and food is to consider "front loading" the cycle. In other words, if numbers are going to be low their lowest at nadir, give Hansel the most of his food prior to nadir. I gave Gabby several installments of her meals. She got fed at pre-shot, then at +1, +2, and +3.

As for food, you can leave food freely available. A timed feeder was a huge help for me. If you are monitoring how much Hansel eats, measure what you leave out. Remember to pick up food 2 hours before shot time and measure what you're picking up. The difference will tell you how much he's eating.

It actually seems like +2 to +6 seems to be his lowest numbers with the current dose, so it's still kinda early.

We're a bit afraid of front loading, he will eat his whole bowl of wet food (2.25 oz) when we give it.
But if we would give more wet food during that meal, will his BG not drop too low until he eats the freely accessible dry food?

It's hard to see how much of the dry food he eats, since there are 3 other cats in the household, this might be a big problem.

The thing that makes most sense for me is keep the same insulin dose, adjust the food doses a to have a little bit less dry food and more wet food each measuring day and see if the insulin has to be lowered.

Edited sheet with what the measuring plan is (on the second tab at the bottom), "x" will be the times we check his BG.

 

[Sienne and Gabby (GA)]

Figuring out when to offer food is a bit of trial and error. I would start by spreading out the canned food versus giving it all at once. You can still supplement with dry especially if it's freely available.

 

[Suzanne & Darcy]

You are doing a great job of testing. I do hope you will be able to get the food situation worked out because those high carb foods definitely are causing need a need for a high insulin dose. At least you got a yellow number for a nadir today so that’s a positive. Unfortunately the carbs will also shorten the duration of the insulin.

 

[Diane Tyler's Mom GA]

Maybe you can find some of these low carb ,low phosphorus foods for Hansel
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

As Bron suggested

• Look into getting automatic timed feeders with a chip attached that only lets Schmidt eat the food. And let all the others eat the low carb wet food.
• An automatic timed feeder with chips for Schmidt and Hansel so they can both eat their appropriate foods

If Schmidt has to eat dry food
If you can find somewhere in Belgium that sells Dr Elsey's Clean Protein Chicken flavor I know that's about 5 or 6% carbs which is ok
I found Amazon International Shipping
https://www.amazon.com/International-Shipping-Direct/b?ie=UTF8&node=230659011

https://www.amazon.com/s?k=Dr Elsey's clean protein&bbn=230659011&crid=40D05B8ZYQMK&sprefix=dr elsey's clean protein ,aps,205&ref=nb_sb_noss

It is expensive though

Also found this web site
https://www.u-buy.co.uk/product/45EDGBG-dr-elsey-x27-s-cleanprotein-formula-dry-cat-food

I hope this helps

 

[Zekono]

Thank you for the responses.
We will conclude our testing for the weekend, he is getting way too annoyed with all the pricks in his ear and we don't want him to get a fear of the process for next tests.
Is a yellow number constant good enough to aim for throughout the day?
The ears look kinda bad too now. But! We got some nice data for friday and saturday.
Will take a look thursday how his ears are, if they are healed enough we will get some more data in.

The shipping from UK/US unfortunately looks too expensive, we'll look in Belgium or maybe Germany (stuff is often cheaper there on amazon than in our own country).
It will be a process but we'll figure out a way to make it work with the dry and wet food by testing different ones, also for Schmidt (he needs urinary tract).

We also have a vet visit planned the 9th of January to which we will take Schmidt (checkup) and Hansel.
Since we have to take a cab and it's at least a 20-25 min drive and then more waiting at the clinic, is there a way we can make it so Hansel doesn't have to pee on the way there or back?
I'm afraid an absorbing pad in his carrier won't be enough to soak it all up, plus he tends to pee against the side of his litter box, so it will probably soak the cab's seats...

 

[Diane Tyler's Mom GA]

If his ears look a little raw


I have read that many members use pure coconut oil, I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears)
It seemed to help with the healing
You might be able to get it at a health food store or just Google pure coconut oil
It's fine if they lick it

@Zekono

 

[Zekono]

We'll apply some of that over the next few days then. My fiancee already uses it on their fur occassionally. Thanks for the tip.